Chapter 11 · Compensation for service-connected disability or death
Subchapter II · Wartime disability compensation
1110Basic entitlement#
For disability resulting from personal injury suffered or disease contracted in line of duty, or for aggravation of a preexisting injury suffered or disease contracted in line of duty, in the active military, naval, air, or space service, during a period of war, the United States will pay to any veteran thus disabled and who was discharged or released under conditions other than dishonorable from the period of service in which said injury or disease was incurred, or preexisting injury or disease was aggravated, compensation as provided in this subchapter, but no compensation shall be paid if the disability is a result of the veteran’s own willful misconduct or abuse of alcohol or drugs.
1111Presumption of sound condition#
For the purposes of section 1110 of this title, every veteran shall be taken to have been in sound condition when examined, accepted, and enrolled for service, except as to defects, infirmities, or disorders noted at the time of the examination, acceptance, and enrollment, or where clear and unmistakable evidence demonstrates that the injury or disease existed before acceptance and enrollment and was not aggravated by such service.
1112Presumptions relating to certain diseases and disabilities#
(a)For the purposes of section 1110 of this title, and subject to the provisions of section 1113 of this title, in the case of any veteran who served for ninety days or more during a period of war—
(1)a chronic disease becoming manifest to a degree of 10 percent or more within one year from the date of separation from such service;
(2)a tropical disease, and the resultant disorders or disease originating because of therapy, administered in connection with such diseases, or as a preventative thereof, becoming manifest to a degree of 10 percent or more within one year from the date of separation from such service, or at a time when standard or accepted treatises indicate that the incubation period thereof commenced during such service;
(3)active tuberculous disease developing a 10 percent degree of disability or more within three years from the date of separation from such service;
(4)multiple sclerosis developing a 10 percent degree of disability or more within seven years from the date of separation from such service;
(5)Hansen’s disease developing a 10 percent degree of disability or more within three years from the date of separation from such service;
shall be considered to have been incurred in or aggravated by such service, notwithstanding there is no record of evidence of such disease during the period of service.
(b)
(1)For the purposes of section 1110 of this title and subject to the provisions of section 1113 of this title, in the case of a veteran who is a former prisoner of war—
(A)a disease specified in paragraph (2) which became manifest to a degree of 10 percent or more after active military, naval, air, or space service shall be considered to have been incurred in or aggravated by such service, notwithstanding that there is no record of such disease during the period of service; and
(B)if the veteran was detained or interned as a prisoner of war for not less than thirty days, a disease specified in paragraph (3) which became manifest to a degree of 10 percent or more after active military, naval, air, or space service shall be considered to have been incurred in or aggravated by such service, notwithstanding that there is no record of such disease during the period of service.
(2)The diseases specified in this paragraph are the following:
(A)Psychosis.
(B)Any of the anxiety states.
(C)Dysthymic disorder (or depressive neurosis).
(D)Organic residuals of frostbite, if the Secretary determines that the veteran was detained or interned in climatic conditions consistent with the occurrence of frostbite.
(E)Post-traumatic osteoarthritis.
(F)Osteoporosis, if the Secretary determines that the veteran has post-traumatic stress disorder (PTSD).
(3)The diseases specified in this paragraph are the following:
(A)Avitaminosis.
(B)Beriberi (including beriberi heart disease).
(C)Chronic dysentery.
(D)Helminthiasis.
(E)Malnutrition (including optic atrophy associated with malnutrition).
(F)Pellagra.
(G)Any other nutritional deficiency.
(H)Cirrhosis of the liver.
(I)Peripheral neuropathy except where directly related to infectious causes.
(J)Irritable bowel syndrome.
(K)Peptic ulcer disease.
(L)Atherosclerotic heart disease or hypertensive vascular disease (including hypertensive heart disease) and their complications (including myocardial infarction, congestive heart failure and arrhythmia).
(M)Stroke and its complications.
(c)
(1)For the purposes of section 1110 of this title, and subject to the provisions of section 1113 of this title, a disease specified in paragraph (2) of this subsection becoming manifest in a radiation-exposed veteran shall be considered to have been incurred in or aggravated during active military, naval, air, or space service, notwithstanding that there is no record of evidence of such disease during a period of such service.
(2)The diseases referred to in paragraph (1) of this subsection are the following:
(A)Leukemia (other than chronic lymphocytic leukemia).
(B)Cancer of the thyroid.
(C)Cancer of the breast.
(D)Cancer of the pharynx.
(E)Cancer of the esophagus.
(F)Cancer of the stomach.
(G)Cancer of the small intestine.
(H)Cancer of the pancreas.
(I)Multiple myeloma.
(J)Lymphomas (except Hodgkin’s disease).
(K)Cancer of the bile ducts.
(L)Cancer of the gall bladder.
(M)Primary liver cancer (except if cirrhosis or hepatitis B is indicated).
(N)Cancer of the salivary gland.
(O)Cancer of the urinary tract.
(P)Bronchiolo-alveolar carcinoma.
(Q)Cancer of the bone.
(R)Cancer of the brain.
(S)Cancer of the colon.
(T)Cancer of the lung.
(U)Cancer of the ovary.
(3)For the purposes of this subsection:
(A)The term “radiation-exposed veteran” means (i) a veteran who, while serving on active duty, participated in a radiation-risk activity, or (ii) an individual who, while a member of a reserve component of the Armed Forces, participated in a radiation-risk activity during a period of active duty for training or inactive duty training.
(B)The term “radiation-risk activity” means any of the following:
(i)Onsite participation in a test involving the atmospheric detonation of a nuclear device (without regard to whether the nation conducting the test was the United States or another nation).
(ii)The occupation of Hiroshima or Nagasaki, Japan, by United States forces during the period beginning on August 6, 1945, and ending on July 1, 1946.
(iii)Internment as prisoner of war in Japan (or service on active duty in Japan immediately following such internment) during World War II which (as determined by the Secretary) resulted in an opportunity for exposure to ionizing radiation comparable to that of veterans described in clause (ii) of this subparagraph.
(iv)Service in a capacity which, if performed as an employee of the Department of Energy, would qualify the individual for inclusion as a member of the Special Exposure Cohort under section 3621(14) of the Energy Employees Occupational Illness Compensation Program Act of 2000 (42 U.S.C. 7384l(14)).
(v)Cleanup of Enewetak Atoll during the period beginning on January 1, 1977, and ending on December 31, 1980.
(vi)Onsite participation in the response effort following the collision of a United States Air Force B–52 bomber and refueling plane that caused the release of four thermonuclear weapons in the vicinity of Palomares, Spain, during the period beginning January 17, 1966, and ending March 31, 1967.
(vii)Onsite participation in the response effort following the on-board fire and crash of a United States Air Force B–52 bomber that caused the release of four thermonuclear weapons in the vicinity of Thule Air Force Base, Greenland, during the period beginning January 21, 1968, and ending September 25, 1968.
(4)A radiation-exposed veteran who receives a payment under the provisions of the Radiation Exposure Compensation Act of 1990 (42 U.S.C. 2210 note) shall not be deprived, by reason of the receipt of that payment, of receipt of compensation to which that veteran is entitled by reason of paragraph (1), but there shall be deducted from payment of such compensation the amount of the payment under that Act.
1113Presumptions rebuttable#
(a)Where there is affirmative evidence to the contrary, or evidence to establish that an intercurrent injury or disease which is a recognized cause of any of the diseases or disabilities within the purview of section 1112, 1116, 1117, 1118, or 1120 of this title, has been suffered between the date of separation from service and the onset of any such diseases or disabilities, or the disability is due to the veteran’s own willful misconduct, service-connection pursuant to section 1112, 1116, 1118, or 1120 of this title, or payments of compensation pursuant to section 1117 of this title, will not be in order.
(b)Nothing in section 1112, 1116, 1117, 1118, or 1120 of this title, subsection (a) of this section, or section 5 of Public Law 98–542 (38 U.S.C. 1154 note) shall be construed to prevent the granting of service-connection for any disease or disorder otherwise shown by sound judgment to have been incurred in or aggravated by active military, naval, air, or space service.
1114Rates of wartime disability compensation#
For the purposes of section 1110 of this title—
(a)if and while the disability is rated 10 percent the monthly compensation shall be $123;
(b)if and while the disability is rated 20 percent the monthly compensation shall be $243;
(c)if and while the disability is rated 30 percent the monthly compensation shall be $376;
(d)if and while the disability is rated 40 percent the monthly compensation shall be $541;
(e)if and while the disability is rated 50 percent the monthly compensation shall be $770;
(f)if and while the disability is rated 60 percent the monthly compensation shall be $974;
(g)if and while the disability is rated 70 percent the monthly compensation shall be $1,228;
(h)if and while the disability is rated 80 percent the monthly compensation shall be $1,427;
(i)if and while the disability is rated 90 percent the monthly compensation shall be $1,604;
(j)if and while the disability is rated as total the monthly compensation shall be $2,673;
(k)if the veteran, as the result of service-connected disability, has suffered the anatomical loss or loss of use of one or more creative organs, or one foot, or one hand, or both buttocks, or blindness of one eye, having only light perception, has suffered complete organic aphonia with constant inability to communicate by speech, or deafness of both ears, having absence of air and bone conduction, or, in the case of a woman veteran, has suffered the anatomical loss of 25 percent or more of tissue from a single breast or both breasts in combination (including loss by mastectomy or partial mastectomy) or has received radiation treatment of breast tissue, the rate of compensation therefor shall be $96 per month for each such loss or loss of use independent of any other compensation provided in subsections (a) through (j) or subsection (s) of this section but in no event to exceed $3,327 per month; and in the event the veteran has suffered one or more of the disabilities heretofore specified in this subsection, in addition to the requirement for any of the rates specified in subsections (l) through (n) of this section, the rate of compensation shall be increased by $96 per month for each such loss or loss of use, but in no event to exceed $4,667 per month;
(l)if the veteran, as the result of service-connected disability, has suffered the anatomical loss or loss of use of both feet, or of one hand and one foot, or is blind in both eyes, with 5/200 visual acuity or less, or is permanently bedridden or with such significant disabilities as to be in need of regular aid and attendance, the monthly compensation shall be $3,327;
(m)if the veteran, as the result of service-connected disability, has suffered the anatomical loss or loss of use of both hands, or of both legs with factors preventing natural knee action with prostheses in place, or of one arm and one leg with factors preventing natural elbow and knee action with prostheses in place, or has suffered blindness in both eyes having only light perception, or has suffered blindness in both eyes, rendering such veteran so significantly disabled as to be in need of regular aid and attendance, the monthly compensation shall be $3,671;
(n)if the veteran, as the result of service-connected disability, has suffered the anatomical loss or loss of use of both arms with factors preventing natural elbow action with prostheses in place, has suffered the anatomical loss of both legs with factors that prevent the use of prosthetic appliances, or has suffered the anatomical loss of one arm and one leg with factors that prevent the use of prosthetic appliances, or has suffered the anatomical loss of both eyes, or has suffered blindness without light perception in both eyes, the monthly compensation shall be $4,176;
(o)if the veteran, as the result of service-connected disability, has suffered disability under conditions which would entitle such veteran to two or more of the rates provided in one or more subsections (l) through (n) of this section, no condition being considered twice in the determination, or if the veteran has suffered bilateral deafness (and the hearing impairment in either one or both ears is service connected) rated at 60 percent or more disabling and the veteran has also suffered service-connected total blindness with 20/200 visual acuity or less, or if the veteran has suffered service-connected total deafness in one ear or bilateral deafness (and the hearing impairment in either one or both ears is service connected) rated at 40 percent or more disabling and the veteran has also suffered service-connected blindness having only light perception or less, or if the veteran has suffered the anatomical loss of both arms with factors that prevent the use of prosthetic appliances, the monthly compensation shall be $4,667;
(p)in the event the veteran’s service-connected disabilities exceed the requirements for any of the rates prescribed in this section, the Secretary may allow the next higher rate or an intermediate rate, but in no event in excess of $4,667. In the event the veteran has suffered service-connected blindness with 5/200 visual acuity or less and (1) has also suffered bilateral deafness (and the hearing impairment in either one or both ears is service connected) rated at no less than 30 percent disabling, the Secretary shall allow the next higher rate, or (2) has also suffered service-connected total deafness in one ear or service-connected anatomical loss or loss of use of one hand or one foot, the Secretary shall allow the next intermediate rate, but in no event in excess of $4,667. In the event the veteran has suffered service-connected blindness, having only light perception or less, and has also suffered bilateral deafness (and the hearing impairment in either one or both ears is service connected) rated at 10 or 20 percent disabling, the Secretary shall allow the next intermediate rate, but in no event in excess of $4,667. In the event the veteran has suffered the anatomical loss or loss of use, or a combination of anatomical loss and loss of use, of three extremities, the Secretary shall allow the next higher rate or intermediate rate, but in no event in excess of $4,667. Any intermediate rate under this subsection shall be established at the arithmetic mean, rounded down to the nearest dollar, between the two rates concerned.
(r)Subject to section 5503(c) of this title, if any veteran, otherwise entitled to compensation authorized under subsection (o) of this section, at the maximum rate authorized under subsection (p) of this section, or at the intermediate rate authorized between the rates authorized under subsections (n) and (o) of this section and at the rate authorized under subsection (k) of this section, is in need of regular aid and attendance, then, in addition to such compensation—
(1)the veteran shall be paid a monthly aid and attendance allowance at the rate of $2,002; or
(2)if the veteran, in addition to such need for regular aid and attendance, is in need of a higher level of care, such veteran shall be paid a monthly aid and attendance allowance at the rate of $2,983, in lieu of the allowance authorized in clause (1) of this subsection, if the Secretary finds that the veteran, in the absence of the provision of such care, would require hospitalization, nursing home care, or other residential institutional care.
For the purposes of clause (2) of this subsection, need for a higher level of care shall be considered to be need for personal health-care services provided on a daily basis in the veteran’s home by a person who is licensed to provide such services or who provides such services under the regular supervision of a licensed health-care professional. The existence of the need for such care shall be determined by a physician employed by the Department or, in areas where no such physician is available, by a physician carrying out such function under contract or fee arrangement based on an examination by such physician. For the purposes of section 1134 of this title, such allowance shall be considered as additional compensation payable for disability.
(s)If the veteran has a service-connected disability rated as total, and (1) has additional service-connected disability or disabilities independently ratable at 60 percent or more, or, (2) by reason of such veteran’s service-connected disability or disabilities, is permanently housebound, then the monthly compensation shall be $2,993. For the purpose of this subsection, the requirement of “permanently housebound” will be considered to have been met when the veteran is substantially confined to such veteran’s house (ward or clinical areas, if institutionalized) or immediate premises due to a service-connected disability or disabilities which it is reasonably certain will remain throughout such veteran’s lifetime.
(t)Subject to section 5503(c) of this title, if any veteran, as the result of service-connected disability, is in need of regular aid and attendance for the residuals of traumatic brain injury, is not eligible for compensation under subsection (r)(2), and in the absence of such regular aid and attendance would require hospitalization, nursing home care, or other residential institutional care, the veteran shall be paid, in addition to any other compensation under this section, a monthly aid and attendance allowance equal to the rate described in subsection (r)(2), which for purposes of section 1134 of this title shall be considered as additional compensation payable for disability. An allowance authorized under this subsection shall be paid in lieu of any allowance authorized by subsection (r)(1).
[(q)Repealed. Pub. L. 90–493, § 4(a), Aug. 19, 1968, 82 Stat. 809.] (repealed)
1115Additional compensation for dependents#
Any veteran entitled to compensation at the rates provided in section 1114 of this title, and whose disability is rated not less than 30 percent, shall be entitled to additional compensation for dependents in the following monthly amounts:
(1)If and while rated totally disabled and—
(A)has a spouse but no child, $150;
(B)has a spouse and one or more children, $259 plus $75 for each child in excess of one;
(C)has no spouse but one or more children, $101 plus $75 for each child in excess of one;
(D)has a parent dependent upon such veteran for support, then, in addition to the above amounts, $120 for each parent so dependent;
(E)notwithstanding the other provisions of this paragraph, the monthly payable amount on account of a spouse who is (i) a patient in a nursing home or (ii) blind, or so nearly blind or significantly disabled as to need or require the regular aid and attendance of another person, shall be $286 for a totally disabled veteran and proportionate amounts for partially disabled veterans in accordance with paragraph (2) of this section; and
(F)notwithstanding the other provisions of this paragraph, the monthly amount payable on account of each child who has attained the age of eighteen years and who is pursuing a course of instruction at an approved educational institution shall be $240 for a totally disabled veteran and proportionate amounts for partially disabled veterans in accordance with paragraph (2) of this section.
(2)If and while rated partially disabled, but not less than 30 percent, in an amount having the same ratio to the amount specified in paragraph (1) of this section as the degree of disability bears to total disability. The amounts payable under this paragraph, if not a multiple of $1, shall be rounded down to the nearest dollar.
1116Presumptions of service connection for diseases associated with exposure to certain herbicide agents; presumption of exposure for veterans who served in certain locations#
(a)at the beginning of section 53(2 (which provides as to the effect of presentment of a bill of exchange) there shall be inserted the words “ Subject to section 75A of this Act, ”; and
(1)For the purposes of section 1110 of this title, and subject to section 1113 of this title—
(A)a disease specified in paragraph (2) of this subsection becoming manifest as specified in that paragraph in a veteran who performed covered service; and
(B)each additional disease (if any) that (i) the Secretary determines in regulations prescribed under this section warrants a presumption of service-connection by reason of having positive association with exposure to an herbicide agent, and (ii) becomes manifest within the period (if any) prescribed in such regulations in a veteran who performed covered service, and while so serving was exposed to that herbicide agent,
shall be considered to have been incurred in or aggravated by such service, notwithstanding that there is no record of evidence of such disease during the period of such service.
(2)The diseases referred to in paragraph (1)(A) of this subsection are the following:
(A)Non-Hodgkin’s lymphoma becoming manifest to a degree of disability of 10 percent or more.
(B)Each soft-tissue sarcoma becoming manifest to a degree of disability of 10 percent or more other than osteosarcoma, chondrosarcoma, Kaposi’s sarcoma, or mesothelioma.
(C)Chloracne or another acneform disease consistent with chloracne becoming manifest to a degree of disability of 10 percent or more within one year after the last date on which the veteran performed covered service.
(D)Hodgkin’s disease becoming manifest to a degree of disability of 10 percent or more.
(E)Porphyria cutanea tarda becoming manifest to a degree of disability of 10 percent or more within a year after the last date on which the veteran performed covered service.
(F)Respiratory cancers (cancer of the lung, bronchus, larynx, or trachea) becoming manifest to a degree of disability of 10 percent or more.
(G)Multiple myeloma becoming manifest to a degree of disability of 10 percent or more.
(H)Diabetes Mellitus (Type 2).
(I)Parkinsonism.
(J)Bladder cancer.
(K)Hypothyroidism.
(L)Monoclonal gammopathy of undetermined significance.
(M)Hypertension.
(3)For purposes of this section, the term “herbicide agent” means a chemical in an herbicide used in support of the United States and allied military operations in the Republic of Vietnam during the period beginning on January 9, 1962, and ending on May 7, 1975.
(b)The Secretary shall ensure that any determination made on or after the date of the enactment of the Sergeant First Class Heath Robinson Honoring our Promise to Address Comprehensive Toxics Act of 2022 regarding a presumption of service connection based on exposure to an herbicide agent under this section is made pursuant to subchapter VII of this chapter, including with respect to assessing reports received by the Secretary from the National Academy of Sciences under section 3 of the Agent Orange Act of 1991 (Public Law 102–4).
(c)For purposes of establishing service connection for a disability or death resulting from exposure to a herbicide agent, including a presumption of service-connection under this section, a veteran who performed covered service,1 shall be presumed to have been exposed during such service to an herbicide agent containing dioxin or 2,4-dichlorophenoxyacetic acid, and may be presumed to have been exposed during such service to any other chemical compound in an herbicide agent, unless there is affirmative evidence to establish that the veteran was not exposed to any such agent during that service.
(d)In this section, the term “covered service” means active military, naval, air, or space service—
(1)performed in the Republic of Vietnam during the period beginning on January 9, 1962, and ending on May 7, 1975;
(3)performed in Laos during the period beginning on December 1, 1965, and ending on September 30, 1969;
(4)performed in Cambodia at Mimot or Krek, Kampong Cham Province during the period beginning on April 16, 1969, and ending on April 30, 1969; or
(5)performed on Guam or American Samoa, or in the territorial waters thereof, during the period beginning on January 9, 1962, and ending on July 31, 1980, or served on Johnston Atoll or on a ship that called at Johnston Atoll during the period beginning on January 1, 1972, and ending on September 30, 1977.
1116APresumptions of service connection for veterans who served offshore of the Republic of Vietnam#
(a)For the purposes of section 1110 of this title, and subject to section 1113 of this title, a disease covered by section 1116 of this title becoming manifest as specified in that section in a veteran who, during active military, naval, or air service, served offshore of the Republic of Vietnam during the period beginning on January 9, 1962, and ending on May 7, 1975, shall be considered to have been incurred in or aggravated by such service, notwithstanding that there is no record of evidence of such disease during the period of such service.
(b)A veteran who, during active military, naval, or air service, served offshore of the Republic of Vietnam during the period beginning on January 9, 1962, and ending on May 7, 1975, shall be presumed to have been exposed during such service to an herbicide agent unless there is affirmative evidence to establish that the veteran was not exposed to any such agent during that service.
(c)
(1)Except as provided by paragraph (2), the effective date of an award under this section shall be determined in accordance with section 5110 of this title.
(2)
(A)Notwithstanding subsection (g) of section 5110 of this title, the Secretary shall determine the effective date of an award based on a claim under this section for an individual described in subparagraph (B) by treating the date on which the individual filed the prior claim specified in clause (i) of such subparagraph as the date on which the individual filed the claim so awarded under this section.
(B)An individual described in this subparagraph is a veteran, or a survivor of a veteran, who meets the following criteria:
(i)The veteran or survivor submitted a claim for disability compensation on or after September 25, 1985, and before January 1, 2020, for a disease covered by this section, and the claim was denied by reason of the claim not establishing that the disease was incurred or aggravated by the service of the veteran.
(ii)The veteran or survivor submits a claim for disability compensation on or after January 1, 2020, for the same condition covered by the prior claim under clause (i), and the claim is approved pursuant to this section.
(d)Notwithstanding any other provision of law, for purposes of this section, the Secretary shall treat a location as being offshore of Vietnam if the location is not more than 12 nautical miles seaward of a line commencing on the southwestern demarcation line of the waters of Vietnam and Cambodia and intersecting the following points:Points Geographic NamesLatitude NorthLongitude East At Hon Nhan Island, Tho Chu Archipelago Kien Giang Province9°15.0′103°27.0′ At Hon Da Island southeast of Hon Khoai Island Minh Hai Province8°22.8′104°52.4′ At Tai Lon Islet, Con Dao Islet in Con Dao-Vung Toa Special Sector8°37.8′106°37.5′ At Bong Lai Islet, Con Dao Islet8°38.9′106°40.3′ At Bay Canh Islet, Con Dao Islet8°39.7′106°42.1′ At Hon Hai Islet (Phu Qui group of islands) Thuan Hai Province9°58.0′109°5.0′ At Hon Doi Islet, Thuan Hai Province12°39.0′109°28.0′ At Dai Lanh point, Phu Khanh Province12°53.8′109°27.2′ At Ong Can Islet, Phu Khanh Province13°54.0′109°21.0′ At Ly Son Islet, Nghia Binh Province15°23.1′109° 9.0′ At Con Co Island, Binh Tri Thien Province17°10.0′107°20.6′
(e)In this section, the term “herbicide agent” has the meaning given that term in section 1116(a)(3) of this title.
1116BPresumption of herbicide exposure for certain veterans who served in Korea#
(a)
(1)For the purposes of section 1110 of this title, and subject to section 1113 of this title, a disease specified in subsection (b) that becomes manifest as specified in that subsection in a veteran described in paragraph (2) shall be considered to have been incurred or aggravated in the line of duty in the active military, naval, or air service, notwithstanding that there is no record of evidence of such disease during the period of such service.
(b)A disease specified in this subsection is—
(1)a disease specified in paragraph (2) of subsection (a) of section 1116 of this title that becomes manifest as specified in that paragraph; or
(2)any additional disease that—
(A)pursuant to subchapter VII of this chapter, the Secretary determines in regulations warrants a presumption of service-connection by reason of having positive association with exposure to an herbicide agent; and
(B)becomes manifest within any period prescribed in such regulations.
(c)For purposes of this section, the term “herbicide agent” has the meaning given such term in section 1821(d) of this title.
1117Compensation for disabilities occurring in Persian Gulf War veterans#
(a)at the beginning of section 53(2 (which provides as to the effect of presentment of a bill of exchange) there shall be inserted the words “ Subject to section 75A of this Act, ”; and
(1)The Secretary may pay compensation under this subchapter to a Persian Gulf veteran with a qualifying chronic disability that became manifest to any degree at any time.
(2)For purposes of this subsection, the term “qualifying chronic disability” means a chronic disability resulting from any of the following (or any combination of any of the following):
(A)An undiagnosed illness.
(B)A medically unexplained chronic multisymptom illness (such as chronic fatigue syndrome, fibromyalgia, and irritable bowel syndrome) that is defined by a cluster of signs or symptoms.
(C)Any diagnosed illness that the Secretary determines in regulations prescribed under subsection (c) warrants a presumption of service-connection.
(b)
(1)Whenever the Secretary determines under section 1118(c) 1 of this title that a presumption of service connection previously established under this section is no longer warranted—
(A)a veteran who was awarded compensation under this section on the basis of the presumption shall continue to be entitled to receive compensation under this section on that basis; and
(2)This subsection shall cease to be effective on September 30, 2011.
(c)
(1)The Secretary shall prescribe regulations to carry out this section.
(2)Those regulations shall include the following:
(A)A description of the period and geographical area or areas of military service in connection with which compensation under this section may be paid.
(B)A description of the illnesses for which compensation under this section may be paid.
(C)A description of any relevant medical characteristic (such as a latency period) associated with each such illness.
(d)If a Persian Gulf veteran at a medical facility of the Department presents with any one symptom associated with Gulf War Illness, the Secretary shall ensure that health care personnel of the Department use a disability benefits questionnaire, or successor questionnaire, designed to identify Gulf War Illness, in addition to any other diagnostic actions the personnel determine appropriate.
(e)A disability for which compensation under this subchapter is payable shall be considered to be service connected for purposes of all other laws of the United States.
(f)For purposes of this section, the term “Persian Gulf veteran” means a veteran who served on active duty in the Armed Forces in the Southwest Asia theater of operations, Afghanistan, Israel, Egypt, Turkey, Syria, or Jordan, during the Persian Gulf War.
(g)For purposes of this section, signs or symptoms that may be a manifestation of an undiagnosed illness or a chronic multisymptom illness include the following:
(1)Fatigue.
(2)Unexplained rashes or other dermatological signs or symptoms.
(3)Headache.
(4)Muscle pain.
(5)Joint pain.
(6)Neurological signs and symptoms.
(7)Neuropsychological signs or symptoms.
(8)Signs or symptoms involving the upper or lower respiratory system.
(9)Sleep disturbances.
(10)Gastrointestinal signs or symptoms.
(11)Cardiovascular signs or symptoms.
(12)Abnormal weight loss.
(13)Menstrual disorders.
(h)
(1)If the Secretary determines with respect to a medical research project sponsored by the Department that it is necessary for the conduct of the project that Persian Gulf veterans in receipt of compensation under this section or section 1118 of this title participate in the project without the possibility of loss of service connection under either such section, the Secretary shall provide that service connection granted under either such section for disability of a veteran who participated in the research project may not be terminated. Except as provided in paragraph (2), notwithstanding any other provision of law any grant of service-connection protected under this subsection shall remain service-connected for purposes of all provisions of law under this title.
(2)Paragraph (1) does not apply in a case in which—
(A)the original award of compensation or service connection was based on fraud; or
(B)it is clearly shown from military records that the person concerned did not have the requisite service or character of discharge.
(3)The Secretary shall publish in the Federal Register a list of medical research projects sponsored by the Department for which service connection granted under this section or section 1118 of this title may not be terminated pursuant to paragraph (1).
(i)
(1)The Secretary shall take such actions as may be necessary to ensure that health care personnel of the Department are appropriately trained to effectively carry out this section.
(2)Not less frequently than once each year, the Secretary shall submit to Congress a report on the actions taken by the Secretary to carry out paragraph (1).
1118Presumptions of service connection for illnesses associated with service in the Persian Gulf during the Persian Gulf War#
(a)at the beginning of section 53(2 (which provides as to the effect of presentment of a bill of exchange) there shall be inserted the words “ Subject to section 75A of this Act, ”; and
(1)For purposes of section 1110 of this title, and subject to section 1113 of this title, each illness, if any, described in paragraph (2) shall be considered to have been incurred in or aggravated by service referred to in that paragraph, notwithstanding that there is no record of evidence of such illness during the period of such service.
(A)the Secretary determines in regulations prescribed under this section to warrant a presumption of service connection by reason of having a positive association with exposure to a biological, chemical, or other toxic agent, environmental or wartime hazard, or preventive medicine or vaccine known or presumed to be associated with service in the Armed Forces in the Southwest Asia theater of operations during the Persian Gulf War; and
(B)becomes manifest within the period, if any, prescribed in such regulations in a veteran who served on active duty in that theater of operations during that war and by reason of such service was exposed to such agent, hazard, or medicine or vaccine.
(3)For purposes of this subsection, a veteran who served on active duty in the Southwest Asia theater of operations during the Persian Gulf War and has an illness described in paragraph (2) shall be presumed to have been exposed by reason of such service to the agent, hazard, or medicine or vaccine associated with the illness in the regulations prescribed under this section unless there is conclusive evidence to establish that the veteran was not exposed to the agent, hazard, or medicine or vaccine by reason of such service.
(4)For purposes of this section, signs or symptoms that may be a manifestation of an undiagnosed illness include the signs and symptoms listed in section 1117(g) of this title.
(b)The Secretary shall ensure that any determination made on or after the date of the enactment of the Sergeant First Class Heath Robinson Honoring our Promise to Address Comprehensive Toxics Act of 2022 regarding a presumption of service connection based on a toxic exposure under this section is made pursuant to subchapter VII of this chapter.
1119Presumptions of toxic exposure#
(a)If a veteran submits to the Secretary a claim for compensation for a service-connected disability under section 1110 of this title with evidence of a disability and a toxic exposure that occurred during active military, naval, air, or space service, the Secretary may, in adjudicating such claim, consider—
(1)any record of the veteran in an exposure tracking record system; and
(b)
(1)The Secretary shall, for purposes of section 1110 and chapter 17 of this title, presume that any covered veteran was exposed to the substances, chemicals, and airborne hazards identified in the list under paragraph (2) during the service of the covered veteran specified in subsection (c)(1), unless there is affirmative evidence to establish that the covered veteran was not exposed to any such substances, chemicals, or hazards in connection with such service.
(2)The Secretary shall—
(A)establish and maintain a list that contains an identification of one or more such substances, chemicals, and airborne hazards as the Secretary, in collaboration with the Secretary of Defense, may determine appropriate for purposes of this section; and
(B)determine, using procedures consistent with section 1172 of this title and through the conduct of a formal evaluation under section 1173 of this title, whether to establish an end date for a covered veteran to qualify for presumptions of exposure under this section, if appropriate, but in no case establish an end date earlier than the last day of the period specified in section 101(33) for the Persian Gulf War.
(3)Beginning not later than two years after the date of the enactment of the Sergeant First Class Heath Robinson Honoring our Promise to Address Comprehensive Toxics Act of 2022, and not less frequently than once every two years thereafter, the Secretary shall submit to the Committee on Veterans’ Affairs of the Senate and the Committee on Veterans’ Affairs of the House of Representatives a report identifying any additions or removals to the list under paragraph (2) during the period covered by the report.
(c)In this section:
(1)The term “covered veteran” means any veteran who—
(A)on or after August 2, 1990, performed active military, naval, air, or space service while assigned to a duty station in, including airspace above—
(i)Bahrain;
(ii)Iraq;
(iii)Kuwait;
(iv)Oman;
(v)Qatar;
(vi)Saudi Arabia;
(vii)Somalia; or
(viii)United Arab Emirates; or
(B)on or after September 11, 2001, performed active military, naval, air, or space service while assigned to a duty station in, including airspace above—
(i)Afghanistan;
(ii)Djibouti;
(iii)Egypt;
(iv)Jordan;
(v)Lebanon;
(vi)Syria;
(vii)Yemen;
(viii)Uzbekistan; or
(ix)any other country determined relevant by the Secretary.
(2)The term “exposure tracking record system”—
(A)means any system, program, or pilot program used by the Secretary of Veterans Affairs or the Secretary of Defense to track how veterans or members of the Armed Forces have been exposed to various occupational or environmental hazards; and
(B)includes the Individual Longitudinal Exposure Record, or successor system.
(3)The term “toxic exposure risk activity” has the meaning given such term in section 1710(e)(4) of this title.
1120Presumption of service connection for certain diseases associated with exposure to burn pits and other toxins#
(a)For the purposes of section 1110 of this title, and subject to section 1113 of this title, a disease specified in subsection (b) becoming manifest in a covered veteran shall be considered to have been incurred in or aggravated during active military, naval, air, or space service, notwithstanding that there is no record of evidence of such disease during the period of such service.
(b)The diseases specified in this subsection are the following:
(1)Asthma that was diagnosed after service of the covered veteran as specified in subsection (c).
(2)The following types of cancer:
(A)Head cancer of any type.
(B)Neck cancer of any type.
(C)Respiratory cancer of any type.
(D)Gastrointestinal cancer of any type.
(E)Reproductive cancer of any type.
(F)Lymphoma cancer of any type.
(G)Kidney cancer.
(H)Brain cancer.
(I)Melanoma.
(J)Pancreatic cancer.
(3)Chronic bronchitis.
(4)Chronic obstructive pulmonary disease.
(5)Constrictive bronchiolitis or obliterative bronchiolitis.
(6)Emphysema.
(7)Granulomatous disease.
(8)Interstitial lung disease.
(9)Pleuritis.
(10)Pulmonary fibrosis.
(11)Sarcoidosis.
(12)Chronic sinusitis.
(13)Chronic rhinitis.
(14)Glioblastoma.
(15)Any other disease for which the Secretary determines, pursuant to regulations prescribed under subchapter VII that a presumption of service connection is warranted based on a positive association with a substance, chemical, or airborne hazard identified in the list under section 1119(b)(2) of this title.
(c)In this section, the term “covered veteran” has the meaning given that term in section 1119(c) of this title.
III · Wartime death compensation
1121Basic entitlement#
The surviving spouse, child or children, and dependent parent or parents of any veteran who died before January 1, 1957 as the result of injury or disease incurred in or aggravated by active military, naval, or air service, in line of duty, during a period of war, shall be entitled to receive compensation at the monthly rates specified in section 1122 of this title.
1122Rates of wartime death compensation#
(a)The monthly rates of death compensation shall be as follows:
(1)Surviving spouse but no child, $87;
(2)Surviving spouse with one child, $121 (with $29 for each additional child);
(3)No surviving spouse but one child, $67;
(4)No surviving spouse but two children, $94 (equally divided);
(5)No surviving spouse but three children, $122 (equally divided) (with $23 for each additional child, total amount to be equally divided);
(6)Dependent parent, $75;
(7)Both dependent parents, $40 each.
(b)The monthly rate of death compensation payable to a surviving spouse or dependent parent under subsection (a) of this section shall be increased by $79 if the payee is (1) a patient in a nursing home or (2) blind, or so nearly blind or significantly disabled as to need or require the regular aid and attendance of another person.
Subchapter IV · Peacetime disability compensation
1131Basic entitlement#
For disability resulting from personal injury suffered or disease contracted in line of duty, or for aggravation of a preexisting injury suffered or disease contracted in line of duty, in the active military, naval, air, or space service, during other than a period of war, the United States will pay to any veteran thus disabled and who was discharged or released under conditions other than dishonorable from the period of service in which said injury or disease was incurred, or preexisting injury or disease was aggravated, compensation as provided in this subchapter, but no compensation shall be paid if the disability is a result of the veteran’s own willful misconduct or abuse of alcohol or drugs.
1132Presumption of sound condition#
For the purposes of section 1131 of this title, every person employed in the active military, naval, air, or space service for six months or more shall be taken to have been in sound condition when examined, accepted and enrolled for service, except as to defects, infirmities, or disorders noted at the time of the examination, acceptance and enrollment, or where evidence or medical judgment is such as to warrant a finding that the disease or injury existed before acceptance and enrollment.
1133Presumptions relating to certain diseases#
(a)For the purposes of section 1131 of this title, and subject to the provisions of subsections (b) and (c) of this section, any veteran who served for six months or more and contracts a tropical disease or a resultant disorder or disease originating because of therapy administered in connection with a tropical disease, or as a preventative thereof, shall be deemed to have incurred such disability in the active military, naval, air, or space service when it is shown to exist within one year after separation from active service, or at a time when standard and accepted treatises indicate that the incubation period thereof commenced during active service.
(b)Service-connection shall not be granted pursuant to subsection (a), in any case where the disease or disorder is shown by clear and unmistakable evidence to have had its inception before or after active military, naval, air, or space service.
(c)Nothing in this section shall be construed to prevent the granting of service-connection for any disease or disorder otherwise shown by sound judgment to have been incurred in or aggravated by active military, naval, air, or space service.
1134Rates of peacetime disability compensation#
For the purposes of section 1131 of this title, the compensation payable for the disability shall be that specified in section 1114 of this title.
1135Additional compensation for dependents#
Any veteran entitled to compensation at the rates provided in section 1134 of this title, and whose disability is rated not less than 30 percent, shall be entitled to additional monthly compensation for dependents as provided in section 1115 of this title.
1137Wartime presumptions for certain veterans#
For the purposes of this subchapter and subchapter V of this chapter and notwithstanding the provisions of sections 1132 and 1133 of this subchapter, the provisions of sections 1111, 1112, and 1113 of this chapter shall be applicable in the case of any veteran who served in the active military, naval, air, or space service after December 31, 1946.
Subchapter VI · General compensation provisions
1151Benefits for persons disabled by treatment or vocational rehabilitation#
(a)Compensation under this chapter and dependency and indemnity compensation under chapter 13 of this title shall be awarded for a qualifying additional disability or a qualifying death of a veteran in the same manner as if such additional disability or death were service-connected. For purposes of this section, a disability or death is a qualifying additional disability or qualifying death if the disability or death was not the result of the veteran’s willful misconduct and—
(1)the disability or death was caused by hospital care, medical or surgical treatment, or examination furnished the veteran under any law administered by the Secretary, either by a Department employee or in a Department facility as defined in section 1701(3)(A) of this title, and the proximate cause of the disability or death was—
(A)carelessness, negligence, lack of proper skill, error in judgment, or similar instance of fault on the part of the Department in furnishing the hospital care, medical or surgical treatment, or examination; or
(B)an event not reasonably foreseeable; or
(2)the disability or death was proximately caused (A) by the provision of training and rehabilitation services by the Secretary (including by a service-provider used by the Secretary for such purpose under section 3115 of this title) as part of an approved rehabilitation program under chapter 31 of this title, or (B) by participation in a program (known as a “compensated work therapy program”) under section 1718 of this title.
(b)
(1)Where an individual is, on or after December 1, 1962, awarded a judgment against the United States in a civil action brought pursuant to section 1346(b) of title 28 or, on or after December 1, 1962, enters into a settlement or compromise under section 2672 or 2677 of title 28 by reason of a disability or death treated pursuant to this section as if it were service-connected, then (except as otherwise provided in paragraph (2)) no benefits shall be paid to such individual for any month beginning after the date such judgment, settlement, or compromise on account of such disability or death becomes final until the aggregate amount of benefits which would be paid but for this subsection equals the total amount included in such judgment, settlement, or compromise.
(2)In the case of a judgment, settlement, or compromise covered by paragraph (1) that becomes final on or after the date of the enactment of this paragraph and that includes an amount that is specifically designated for a purpose for which benefits are provided under chapter 21 or 39 of this title (hereinafter in this paragraph referred to as the “offset amount”), if such judgment, settlement, or compromise becomes final before the date of the award of benefits under chapter 21 or 39 for the purpose for which the offset amount was specifically designated—
(A)the amount of such award shall be reduced by the offset amount; and
(B)if the offset amount is greater than the amount of such award, the excess amount received pursuant to the judgment, settlement or compromise, shall be offset against benefits otherwise payable under this chapter.
(c)A qualifying additional disability under this section shall be treated in the same manner as if it were a service-connected disability for purposes of the following provisions of this title:
(1)Chapter 21, relating to specially adapted housing.
(2)Chapter 39, relating to automobiles and adaptive equipment.
1152Persons heretofore having a compensable status#
The death and disability benefits of this chapter shall, notwithstanding the service requirements thereof, be granted to persons heretofore recognized by law as having a compensable status, including persons whose claims are based on war or peacetime service rendered before April 21, 1898.
1153Aggravation#
A preexisting injury or disease will be considered to have been aggravated by active military, naval, air, or space service, where there is an increase in disability during such service, unless there is a specific finding that the increase in disability is due to the natural progress of the disease.
1154Consideration to be accorded time, place, and circumstances of service#
(a)The Secretary shall include in the regulations pertaining to service-connection of disabilities (1) additional provisions in effect requiring that in each case where a veteran is seeking service-connection for any disability due consideration shall be given to the places, types, and circumstances of such veteran’s service as shown by such veteran’s service record, the official history of each organization in which such veteran served, such veteran’s medical records, and all pertinent medical and lay evidence, and (2) the provisions required by section 5 of the Veterans’ Dioxin and Radiation Exposure Compensation Standards Act (Public Law 98–542; 98 Stat. 2727).
(b)In the case of any veteran who engaged in combat with the enemy in active service with a military, naval, air, or space organization of the United States during a period of war, campaign, or expedition, the Secretary shall accept as sufficient proof of service-connection of any disease or injury alleged to have been incurred in or aggravated by such service satisfactory lay or other evidence of service incurrence or aggravation of such injury or disease, if consistent with the circumstances, conditions, or hardships of such service, notwithstanding the fact that there is no official record of such incurrence or aggravation in such service, and, to that end, shall resolve every reasonable doubt in favor of the veteran. Service-connection of such injury or disease may be rebutted by clear and convincing evidence to the contrary. The reasons for granting or denying service-connection in each case shall be recorded in full.
1155Authority for schedule for rating disabilities#
The Secretary shall adopt and apply a schedule of ratings of reductions in earning capacity from specific injuries or combination of injuries. The ratings shall be based, as far as practicable, upon the average impairments of earning capacity resulting from such injuries in civil occupations. The schedule shall be constructed so as to provide ten grades of disability and no more, upon which payments of compensation shall be based, namely, 10 percent, 20 percent, 30 percent, 40 percent, 50 percent, 60 percent, 70 percent, 80 percent, 90 percent, and total, 100 percent. The Secretary shall from time to time readjust this schedule of ratings in accordance with experience. However, in no event shall such a readjustment in the rating schedule cause a veteran’s disability rating in effect on the effective date of the readjustment to be reduced unless an improvement in the veteran’s disability is shown to have occurred.
1156Temporary disability ratings#
(a)
(1)For the purpose of providing disability compensation under this chapter to veterans, the Secretary shall assign a temporary disability rating to a veteran as follows:
(A)To a veteran who—
(i)was discharged or released from active duty not more than 365 days before the date such veteran submits a claim for disability compensation under this chapter;
(ii)has one or more disabilities for which a rating of total is not immediately assignable—
(I)under the regular provisions of the schedule of ratings; or
(II)on the basis of individual unemployability; and
(iii)has one or more—
(I)severe disabilities that result in substantially gainful employment not being feasible or advisable; or
(II)healed, unhealed, or incompletely healed wounds or injuries that make material impairment of employability likely.
(C)To a veteran who has a service-connected disability that requires hospital treatment or observation in a Department of Veterans Affairs or approved hospital for a period in excess of 21 days.
(D)To a veteran who has a service-connected disability that has required convalescent care or treatment at hospital discharge (regular discharge or release to non-bed care) or outpatient release that meets the requirements of regulations prescribed by the Secretary.
(b)
(1)Except as provided in paragraph (2), a temporary disability rating assigned to a veteran under this section shall remain in effect as follows:
(A)For a veteran who is assigned a temporary disability rating under subsection (a)(1)(A), until the later of the date that is—
(i)12 months after the date of discharge or release from active duty; or
(ii)provided in regulations prescribed by the Secretary.
(C)For a veteran who is assigned a temporary disability rating under subsection (a)(1)(C), until the later of the date that is—
(i)the last day of the month in which the veteran is discharged from the hospital as described in such subsection (a)(1)(C); or
(ii)provided in regulations prescribed by the Secretary.
(D)For a veteran who is assigned a temporary disability rating under subsection (a)(1)(D), until the date that is provided in regulations prescribed by the Secretary.
(2)The Secretary may extend a temporary disability rating assigned to a veteran under subsection (a) beyond the applicable termination date under paragraph (1) if the Secretary determines that such an extension is appropriate.
(c)The Secretary shall prescribe regulations to carry out the provisions of this section.
(d)Nothing in this section shall be construed to preclude the Secretary from providing a temporary disability rating under an authority other than this section.
1157Combination of certain ratings#
The Secretary shall provide for the combination of ratings and pay compensation at the rates prescribed in subchapter II of this chapter to those veterans who served during a period of war and during any other time, who have suffered disability in line of duty in each period of service.
1158Disappearance#
Where a veteran receiving compensation under this chapter disappears, the Secretary may pay the compensation otherwise payable to the veteran to such veteran’s spouse, children, and parents. Payments made to such spouse, child, or parent under the preceding sentence shall not exceed the amounts payable to each if the veteran had died from service-connected disability.
1159Protection of service connection#
Service connection for any disability or death granted under this title which has been in force for ten or more years shall not be severed on or after January 1, 1962, except upon a showing that the original grant of service connection was based on fraud or it is clearly shown from military records that the person concerned did not have the requisite service or character of discharge. The mentioned period shall be computed from the date determined by the Secretary as the date on which the status commenced for rating purposes.
1160Special consideration for certain cases of loss of paired organs or extremities#
(a)Where a veteran has suffered—
(1)impairment of vision in one eye as a result of service-connected disability and impairment of vision in the other eye as a result of non-service-connected disability not the result of the veteran’s own willful misconduct and—
(A)the impairment of vision in each eye is rated at a visual acuity of 20/200 or less; or
(B)the peripheral field of vision for each eye is 20 degrees or less;
(2)the loss or loss of use of one kidney as a result of service-connected disability and involvement of the other kidney as a result of non-service-connected disability not the result of the veteran’s own willful misconduct;
(3)deafness compensable to a degree of 10 percent or more in one ear as a result of service-connected disability and deafness in the other ear as the result of non-service-connected disability not the result of the veteran’s own willful misconduct;
(4)the loss or loss of use of one hand or one foot as a result of service-connected disability and the loss or loss of use of the other hand or foot as a result of non-service-connected disability not the result of the veteran’s own willful misconduct; or
(5)permanent service-connected disability of one lung, rated 50 percent or more disabling, in combination with a non-service-connected disability of the other lung that is not the result of the veteran’s own willful misconduct,
the Secretary shall assign and pay to the veteran the applicable rate of compensation under this chapter as if the combination of disabilities were the result of service-connected disability.
(b)If a veteran described in subsection (a) of this section receives any money or property of value pursuant to an award in a judicial proceeding based upon, or a settlement or compromise of, any cause of action for damages for the non-service-connected disability described in such subsection, the increase in the rate of compensation otherwise payable under this section shall not be paid for any month following a month in which any such money or property is received until such time as the total of the amount of such increase that would otherwise have been payable equals the total of the amount of any such money received and the fair market value of any such property received.
1161Payment of disability compensation in disability severance cases#
The deduction of disability severance pay from disability compensation, to the extent required by section 1212(d) of title 10, shall be made at a monthly rate not in excess of the rate of compensation to which the former member would be entitled based on the degree of such former member’s disability as determined on the initial Department rating.
1162Clothing allowance#
(a)The Secretary, under regulations which the Secretary shall prescribe, shall pay a clothing allowance of $716 1 per year to each veteran who—
(1)because of a service-connected disability, wears or uses a prosthetic or orthopedic appliance (including a wheelchair) which the Secretary determines tends to wear out or tear the clothing of the veteran; or
(2)uses medication which—
(A)a physician has prescribed for a skin condition which is due to a service-connected disability; and
(B)the Secretary determines causes irreparable damage to the veteran’s outergarments.
(b)Payments made to a veteran under subsection (a) shall continue on an automatically recurring annual basis until the earlier of the following:
(1)The date on which the veteran elects to no longer receive such payments.
(2)The date on which the Secretary determines the veteran is no longer eligible pursuant to subsection (c).
(c)
(2)The Secretary shall prescribe standards for determining whether a claim for a clothing allowance is based on a veteran’s wearing or use of a prosthetic, orthopedic appliance (including a wheelchair), or medication whose wear or tear or irreparable damage on a veteran’s outergarments or clothing is as likely as not subject to no change for the duration of such wearing or use.
(3)
(A)If the Secretary determines, pursuant to standards prescribed under paragraph (2), that a claim for a clothing allowance is based on wear or tear or irreparable damage that is as likely as not subject to no change, the veteran shall continue to be deemed eligible for receipt of a clothing allowance under this section until the Secretary—
(i)receives notice under subparagraph (B); or
(ii)finds otherwise under subparagraph (C) or (D).
(B)The Secretary shall require a veteran who is receiving a clothing allowance under subsection (a), based on the wearing or use of a prosthetic, orthopedic appliance (including a wheelchair), or medication, to notify the Secretary when the veteran terminates the wearing or use of such a prosthetic, orthopedic appliance, or medication.
(C)For each veteran who is receiving a clothing allowance under subsection (a), based on the wearing or use of a prosthetic, orthopedic appliance (including a wheelchair), or medication, the Secretary shall periodically review the veteran’s Department records for evidence that the veteran has terminated the wearing or use of such a prosthetic, orthopedic appliance, or medication.
(D)If a veteran who is receiving a clothing allowance under subsection (a), based on the wearing or use of a prosthetic, orthopedic appliance (including a wheelchair), or medication, has received such clothing allowance beyond the prescribed or intended lifespan of such prosthetic, orthopedic appliance, or medication, the Secretary may periodically request the veteran to attest to continued usage.
(4)If the Secretary determines that a claim for a clothing allowance under subsection (a) does not meet the requirements of paragraph (3)(A), then the Secretary may require the veteran to recertify the veteran’s continued eligibility for a clothing allowance under this section periodically, but not more frequently than once each year.
(5)When reviewing a claim under this subsection, the Secretary shall evaluate the evidence presented by the veteran and such other relevant evidence as the Secretary determines appropriate.
(d)If the Secretary determines, as the result of a review of a claim conducted under subsection (c), that the veteran who submitted such claim no longer meets the requirements specified in subsection (a), the Secretary shall—
(1)provide to the veteran notice of such determination that includes a description of applicable actions that may be taken following the determination, including the actions specified in section 5104C of this title; and
(2)discontinue the clothing allowance based on such claim.
1163Trial work periods and vocational rehabilitation for certain veterans with total disability ratings#
(a)at the beginning of section 53(2 (which provides as to the effect of presentment of a bill of exchange) there shall be inserted the words “ Subject to section 75A of this Act, ”; and
(1)The disability rating of a qualified veteran who begins to engage in a substantially gainful occupation after January 31, 1985, may not be reduced on the basis of the veteran having secured and followed a substantially gainful occupation unless the veteran maintains such an occupation for a period of 12 consecutive months.
(2)For purposes of this section, the term “qualified veteran” means a veteran who has a service-connected disability, or service-connected disabilities, not rated as total but who has been awarded a rating of total disability by reason of inability to secure or follow a substantially gainful occupation as a result of such disability or disabilities.
(b)The Secretary shall make counseling services described in section 3104(a)(2) of this title and placement and postplacement services described in section 3104(a)(5) of this title available to each qualified veteran (whether or not the veteran is participating in a vocational rehabilitation program under chapter 31 of this title).
(c)
(1)In the case of each award after January 31, 1985, of a rating of total disability described in subsection (a)(2) of this section to a veteran, the Secretary shall provide to the veteran, at the time that notice of the award is provided to the veteran, a statement providing—
(A)notice of the provisions of this section;
(B)information explaining the purposes and availability of and eligibility for, and the procedures for pursuing, a vocational rehabilitation program under chapter 31 of this title; and
(C)a summary description of the scope of services and assistance available under that chapter.
(2)After providing the notice required under paragraph (1) of this subsection, the Secretary shall offer the veteran the opportunity for an evaluation under section 3106(a) of this title.
1164Presumptions of service-connection for Coronavirus Disease 2019#
(a)
(1)For purposes of laws administered by the Secretary and subject to section 1113 of this title, if symptoms of Coronavirus Disease 2019 (in this section referred to as “COVID–19”) described in subsection (d) manifest within one of the manifestation periods described in paragraph (2) in an individual who served in a qualifying period of duty described in subsection (b)—
(A)infection with severe acute respiratory syndrome coronavirus 2 (in this section referred to as “SARS–CoV–2”) shall be presumed to have occurred during the qualifying period of duty;
(B)COVID–19 shall be presumed to have been incurred during the qualifying period of duty; and
(C)if the individual becomes disabled or dies as a result of COVID–19, it shall be presumed that the individual became disabled or died during the qualifying period of duty for purposes of establishing that the individual served in the active military, naval, or air service.
(2)
(A)The manifestation periods described in this paragraph are the following:
(i)During a qualifying period of duty described in subsection (b), if that period of duty was more than 48 continuous hours in duration.
(ii)Within 14 days after the individual’s completion of a qualifying period of duty described in subsection (b).
(iii)An additional period prescribed under subparagraph (B).
(B)
(i)If the Secretary determines that a manifestation period of more than 14 days after completion of a qualifying period of service is appropriate for the presumptions under paragraph (1), the Secretary may prescribe that additional period by regulation.
(ii)A determination under clause (i) shall be made in consultation with the Director of the Centers for Disease Control and Prevention.
(b)A qualifying period of duty described in this subsection is—
(1)a period of active duty performed—
(A)during the national emergency declared by the President under the National Emergencies Act (50 U.S.C. 1601 et seq.); and
(B)before the date that is three years after the date of the enactment of the Johnny Isakson and David P. Roe, M.D. Veterans Health Care and Benefits Improvement Act of 2020; or
(2)training duty under title 10 or full-time National Guard duty (as defined in section 101 of title 10), performed under orders issued on or after March 13, 2020—
(A)during the national emergency declared by the President under the National Emergencies Act (50 U.S.C. 1601 et seq.); and
(B)before the date that is three years after the date of the enactment of the Johnny Isakson and David P. Roe, M.D. Veterans Health Care and Benefits Improvement Act of 2020.
(c)When, pursuant to subsection (a), COVID–19 is presumed to have been incurred during a qualifying period of duty described in subsection (b)(2)—
(1)COVID–19 shall be deemed to have been incurred in the line of duty during a period of active military, naval, or air service; and
(2)where entitlement to benefits under this title is predicated on the individual who was disabled or died being a veteran, benefits for disability or death resulting from COVID–19 as described in subsection (a) shall be paid or furnished as if the individual was a veteran, without regard to whether the period of duty would constitute active military, naval, or air service under section 101 of this title.
(d)For purposes of subsection (a), symptoms of COVID–19 are those symptoms that competent medical evidence demonstrates are experienced by an individual affected and directly related to COVID–19.
(e)If there is a question of whether the symptoms experienced by an individual described in paragraph (1) of subsection (a) during a manifestation period described in paragraph (2) of such subsection are attributable to COVID–19 resulting from infection with SARS–CoV–2 during the qualifying period of duty, in determining whether a medical examination or medical opinion is necessary to make a decision on the claim within the meaning of section 5103A(d) of this title, a qualifying period of duty described in subsection (b) of this section shall be treated as if it were active military, naval, or air service for purposes of section 5103A(d)(2)(B) of this title.
1165Choice of sex of medical examiner for certain disabilities#
(a)The Secretary shall ensure that a veteran who requires a medical examination from a covered medical provider in support of a claim for compensation under this chapter for a mental or physical health condition that resulted from a physical assault of a sexual nature, battery of a sexual nature, or sexual harassment may designate the sex of the medical provider who provides such medical examination.
(b)For purposes of this section, a covered medical provider is any medical provider who is employed by the Department or is under any contract with the Department to provide a medical examination or a medical opinion when such an examination or opinion is necessary to make a decision on a claim.
1166Claims involving military sexual trauma#
(a)
(1)The Secretary shall establish specialized teams to process claims for compensation for a covered mental health condition based on military sexual trauma experienced by a veteran during active military, naval, air, or space service.
(2)A peer support specialist of the Department—
(A)shall not be responsible for providing any assistance to a veteran regarding a claim described in paragraph (1), other than counseling services, guidance, and support, pursuant to duties determined by the Under Secretary for Health; and
(B)shall not participate in the adjudication of such a claim.
(b)The Secretary shall include, in forms for claims described in subsection (a), an option for a veteran to elect to be referred to a military sexual trauma coordinator of the Veterans Health Administration at the facility of the Department nearest to the residence of such veteran.
(c)
(1)The Secretary shall ensure that members of teams established under subsection (a) are trained to identify markers indicating military sexual trauma.
(2)The Secretary shall ensure that peer support specialists of the Department receive annual training on how to provide peer support regarding military sexual trauma.
(3)The Secretary shall provide annual training, regarding the processing of claims described in subsection (a), to the following individuals:
(A)Military sexual trauma coordinators of the Veterans Health Administration.
(B)Peer support specialists of the Department.
(d)In this section:
(1)The term “covered mental health condition” means post-traumatic stress disorder, anxiety, depression, or other mental health diagnosis described in the current version of the Diagnostic and Statistical Manual of Mental Disorders published by the American Psychiatric Association that the Secretary determines to be related to military sexual trauma.
(2)The term “military sexual trauma” means, with respect to a veteran, a physical assault of a sexual nature, battery of a sexual nature, or sexual harassment during active military, naval, air, or space service.
1167Mental health consultations#
(a)Not later than 30 days after the date on which a veteran submits to the Secretary a claim for compensation under this chapter for a service-connected disability relating to a mental health diagnosis, the Secretary shall offer the veteran a mental health consultation to assess the mental health needs of, and care options for, the veteran.
(b)The Secretary shall—
(2)ensure that a veteran offered a mental health consultation under subsection (a) may elect to receive such consultation during the one-year period beginning on the date on which the consultation is offered or during such longer period beginning on such date as the Secretary considers appropriate.
1168Medical nexus examinations for toxic exposure risk activities#
(a)
(1)Except as provided in subsection (b), if a veteran submits to the Secretary a claim for compensation for a service-connected disability under section 1110 of this title with evidence of a disability and evidence of participation in a toxic exposure risk activity during active military, naval, air, or space service, and such evidence is not sufficient to establish a service connection for the disability, the Secretary shall—
(A)provide the veteran with a medical examination under section 5103A(d) of this title; and
(B)obtain a medical opinion (to be requested by the Secretary in connection with the medical examination under subparagraph (A)) as to whether it is at least as likely as not that there is a nexus between the disability and the toxic exposure risk activity.
(2)When providing the Secretary with a medical opinion under paragraph (1)(B) for a veteran, the health care provider shall consider—
(A)the total potential exposure through all applicable military deployments of the veteran; and
(B)the synergistic, combined effect of all toxic exposure risk activities of the veteran.
(3)The requirement under paragraph (2)(B) shall not be construed as requiring a health care provider to consider the synergistic, combined effect of each of the substances, chemicals, and airborne hazards identified in the list under section 1119(b)(2) of this title.
(b)Subsection (a) shall not apply if the Secretary determines there is no indication of an association between the disability claimed by the veteran and the toxic exposure risk activity for which the veteran submitted evidence.
(c)In this section, the term “toxic exposure risk activity” has the meaning given that term in section 1710(e)(4) of this title.
VII · Determinations relating to presumptions of service connection based on toxic exposure
1171Procedures to determine presumptions of service connection based on toxic exposure; definitions#
(a)The Secretary shall determine whether to establish, or to remove, presumptions of service connection based on toxic exposure pursuant to this subchapter, whereby—
(1)under section 1172 of this title—
(A)the Secretary provides—
(i)public notice regarding what formal evaluations the Secretary plans to conduct; and
(ii)the public an opportunity to comment on the proposed formal evaluations;
(B)the working group established under subsection (b) of such section provides—
(i)advice to the Secretary on toxic-exposed veterans and cases in which veterans who, during active military, naval, air, or space service, may have experienced a toxic exposure or their dependents may have experienced a toxic exposure while the veterans were serving in the active military, naval, air, or space service;
(ii)recommendations to the Secretary on corrections needed in the Individual Longitudinal Exposure Record to better reflect veterans and dependents described in clause (i); and
(iii)recommendations to the Secretary regarding which cases of possible toxic exposure should be reviewed;
(2)the Secretary provides for formal evaluations of such recommendations under section 1173 of this title and takes into account reports received by the Secretary from the National Academies of Sciences, Engineering, and Medicine under section 1176 of this title; and
(3)the Secretary issues regulations under section 1174 of this title.
(b)In this subchapter:
(1)The term “illness” includes a disease or other condition affecting the health of an individual, including mental and physical health.
(2)The term “Individual Longitudinal Exposure Record” means the data system maintained under section 996 of title 10.
1172Annual notice and opportunity for public comment#
(a)
(1)
(A)Not less frequently than once each year, the Secretary shall publish in the Federal Register notice of the formal evaluations that the Secretary plans to conduct pursuant to section 1173 of this title.
(B)Each notice published under subparagraph (A) shall include, for each formal evaluation referred to in the notice, an explanation as to why the military environmental exposures and adverse health outcomes that are the subject of the formal evaluation were chosen by the Secretary for formal evaluation under section 1173 of this title.
(2)
(A)With each notice published under paragraph (1), the Secretary shall seek public comment on the military environmental exposures and adverse health outcomes that are the subject of the formal evaluations referred to in the notice.
(B)The Secretary shall—
(i)consider all public comment received under subparagraph (A); and
(ii)publish in the Federal Register a response to the comments received under subparagraph (A).
(3)
(A)For each notice published under paragraph (1), the Secretary shall hold an open meeting for members of the public to voice their comments in response to the notice.
(B)To help evaluate presumptions of service connection, the Secretary shall, not less frequently than quarterly, collaborate with, partner with, and give weight to the advice of veterans service organizations and such other stakeholders as the Secretary considers appropriate.
(4)Failure to include a military environmental exposure or adverse health effect in a Federal Register notice published pursuant to subsection (a) shall not preclude the Secretary from initiating a formal evaluation of such exposure or health effect.
(b)
(1)The Secretary shall establish a working group within the Department (in this section referred to as the “Working Group”).
(2)The Working Group shall include personnel of the Veterans Health Administration and the Veterans Benefits Administration.
(3)The Secretary shall consult with, and seek the advice of, the Working Group with respect to cases in which—
(A)a veteran may have, during active military, naval, air, or space service, experienced a toxic exposure; or
(c)
(1)The Working Group shall assess cases of the toxic exposure of veterans and their dependents that occurred during active military, naval, air, or space service, including by conducting ongoing surveillance and reviewing such exposure described in scientific literature, media reports, information from veterans, and information from Congress.
(2)The assessments under paragraph (1) shall cover suspected and known toxic exposures occurring during active military, naval, air, or space service, including by identifying and evaluating new and emerging toxic exposures that are not recognized under existing presumptions of service connection.
(3)The Working Group may conduct an assessment under paragraph (1) in response to a comment received under paragraph (2) or (3) of subsection (a).
(4)The Working Group shall, in consultation with the Secretary of Defense, on a periodic basis, assess the Individual Longitudinal Exposure Record to ensure the accuracy of data collected.
(d)
(1)Following an assessment of a case of the toxic exposure of veterans that occurred during active military, naval, air, or space service under subsection (c), or their dependents, the Working Group may develop a recommendation for formal evaluation under section 1173 of this title to conduct a review of the health effects related to the case of exposure if the Working Group determines that the research may change the current understanding of the relationship between an exposure to an environmental hazard and adverse health outcomes in humans.
(2)Upon receipt of evidence suggesting that previous findings regarding the periods and locations of exposure covered by an existing presumption of service connection are no longer supported, the Working Group may nominate such evidence for formal evaluation under section 1173 of this title to modify the periods and locations.
(e)Not less frequently than once each year, the Working Group shall submit to the Secretary, the Committee on Veterans’ Affairs of the Senate, and the Committee on Veterans’ Affairs of the House of Representatives, and make publicly available, a report on—
(1)recommendations developed under subsection (d), if any; and
(2)recommendations for such legislative or administrative action as the Working Group considers necessary for the Working Group to be more effective in carrying out the requirements of this section.
(f)In response to each report submitted under subsection (e), the Secretary shall, not later than 30 days after receiving the report, initiate a formal evaluation pursuant to section 1173 of this title.
1173Formal evaluation of recommendations#
(a)The Secretary shall establish a process to conduct a formal evaluation with respect to each recommendation made by the Working Group under section 1172 of this title.
(b)The Secretary shall ensure that each formal evaluation under subsection (a) covers the following:
(1)Scientific evidence, based on the review of available scientific literature, including human, toxicological, animal, and methodological studies, and other factors.
(2)Claims data, based on the review of claim rate, grant rate, and service connection prevalence, and other factors.
(3)Other factors the Secretary determines appropriate, such as—
(A)the level of disability and mortality caused by the health effects related to the case of toxic exposure being evaluated;
(B)the quantity and quality of the information available and reviewed;
(C)the feasibility of and period for generating relevant information and evidence;
(D)whether such health effects are combat- or deployment-related;
(E)the ubiquity or rarity of the health effects; and
(F)any time frame during which a health effect must become manifest.
(c)
(1)The Secretary shall ensure that each formal evaluation under subsection (a)—
(A)reviews scientific evidence in a manner that—
(i)conforms to principles of scientific and data integrity;
(ii)is free from suppression or distortion of scientific or technological findings, data, information, conclusions, or technical results; and
(B)
(i)evaluates the likelihood that a positive association exists between an illness and a toxic exposure while serving in the active military, naval, air, or space service; and
(ii)assesses the toxic exposures and illnesses and determines whether the evidence supports a finding of a positive association between the toxic exposure and the illness.
(2)In carrying out paragraph (1)(B)(ii), a formal evaluation under subsection (a) shall include reviewing all relevant data to determine the strength of evidence for a positive association based on the following four categories:
(A)The “sufficient” category, where the evidence is sufficient to conclude that a positive association exists.
(B)The “equipoise and above” category, where the evidence is sufficient to conclude that a positive association is at least as likely as not, but not sufficient to conclude that a positive association exists.
(C)The “below equipoise” category, where the evidence is not sufficient to conclude that a positive association is at least as likely as not, or is not sufficient to make a scientifically informed judgment.
(D)The “against” category, where the evidence suggests the lack of a positive association.
(d)Not later than 120 days after the date on which a formal evaluation is commenced, the element of the Department that conducts the evaluation shall submit to the Secretary a recommendation with respect to establishing a presumption of service connection for the toxic exposure and illness, or modifying an existing presumption of service connection, covered by the evaluation.
1174Regulations regarding presumptions of service connection based on toxic exposure#
(a)Not later than 160 days after the date on which the Secretary receives a recommendation to establish or modify a presumption of service connection under section 1173 of this title—
(1)if the Secretary determines, in the discretion of the Secretary, that the presumption, or modification, is warranted, the Secretary shall—
(A)commence issuing regulations in accordance with the provisions of subchapter II of chapter 5 of title 5 (commonly referred to as the Administrative Procedures Act) setting forth the presumption or commence revising regulations to carry out such modification; and
(B)include in such regulations any time frame during which a health effect must become manifest; or
(2)if the Secretary determines, in the discretion of the Secretary, that the presumption, or modification, is not warranted, the Secretary shall publish in the Federal Register a notice of the determination, including the reasons supporting the determination.
(b)
(1)
(A)The Secretary may—
(i)issue a regulation to remove an illness from a presumption of service connection previously established pursuant to a regulation issued under subsection (a); and
(ii)issue a regulation to remove a presumption of service connection established pursuant to title IV of the Sergeant First Class Heath Robinson Honoring our Promise to Address Comprehensive Toxics Act of 2022 if the Secretary concludes that evidence suggests the lack of a positive association between the disease and the toxic exposure.
(B)Under subparagraph (A)(ii), the Secretary shall not consider the lack of evidence as sufficient to support a decision for removal of a presumption.
(2)Whenever an illness is removed from regulations pursuant to paragraph (1), or the periods and locations of exposure covered by a presumption of service connection are modified under subsection (a)—
1175Authority to modify process; congressional oversight#
(a)The Secretary may modify the process under which the working group established under subsection (b) of section 1172 of this title conducts assessments under such section, the Secretary conducts formal evaluations under section 1173 of this title, and issues regulations under section 1174 of this title if—
(1)such evaluations cover the evidence, data, and factors required by subsection (b) of such section 1173; and
(2)a period of 180 days has elapsed following the date on which the Secretary submits the notice under subsection (b) regarding the modification.
(b)If the Secretary proposes to modify the process under which the working group established under subsection (b) of section 1172 of this title conducts assessments under such section, the process under which the Secretary conducts formal evaluations under section 1173 of this title, or issues regulations under section 1174 of this title, the Secretary shall submit to the Committee on Veterans’ Affairs of the Senate and the Committee on Veterans’ Affairs of the House of Representatives a notice of the proposed modifications containing the following:
(1)A description of the proposed modifications.
(2)A description of any exceptions to the requirements of such sections that are proposed because of limited available scientific evidence, and a description of how such evaluations will be conducted.
1176Agreement with National Academies of Sciences, Engineering, and Medicine concerning toxic exposures#
(a)The purpose of this section is to provide for the National Academies of Sciences, Engineering, and Medicine (in this section referred to as the “Academies”), an independent nonprofit scientific organization with appropriate expertise that is not part of the Federal Government, to review and evaluate the available scientific evidence regarding associations between diseases and toxic exposures.
(b)
(1)The Secretary shall seek to enter into a five-year agreement with the Academies to perform the services covered by this section.
(2)The Secretary shall seek to enter into an agreement described in paragraph (1) not later than 60 days after the date of the enactment of the Sergeant First Class Heath Robinson Honoring our Promise to Address Comprehensive Toxics Act of 2022.
(3)An agreement under this section may be extended in five-year increments.
(c)Under an agreement between the Secretary and the Academies under this section, the Academies shall review and summarize the scientific evidence, and assess the strength thereof, concerning the association between toxic exposures during active military, naval, air, or space service and each disease suspected to be associated with such exposure in the human population.
(d)For each disease reviewed under subsection (c), the Academies shall determine, to the extent that available scientific data permit meaningful determinations—
(1)whether an association exists between toxic exposures and the occurrence of the disease, taking into account the strength of the scientific evidence and the appropriateness of the statistical and epidemiological methods used to detect the association;
(2)the increased risk of the disease among those reporting toxic exposures during active military, naval, air, or space service;
(3)whether there exists a plausible biological mechanism or other evidence of a positive association between the toxic exposure and the occurrence of the disease; and
(4)determine the strength of evidence for a positive association based on categories furnished under section 1173 of this title.
(e)The head of each relevant Federal agency, including the Secretary of Defense, shall cooperate fully with the Academies in performing the services covered by this section.
(f)
(1)Under an agreement between the Secretary and the Academies under this section, the Academies shall make any recommendations for additional scientific studies to resolve areas of continuing scientific uncertainty relating to toxic exposures.
(2)In making recommendations under paragraph (1), the Academies shall consider—
(A)the scientific information that is available at the time of the recommendation;
(B)the value and relevance of the information that could result from additional studies; and
(C)the cost and feasibility of carrying out such additional studies.
(g)
(1)
(A)Under an agreement between the Secretary and the Academies under this section, not later than one year after the date of the enactment of the Sergeant First Class Heath Robinson Honoring our Promise to Address Comprehensive Toxics Act of 2022, the Academies shall submit to the Secretary, the Committee on Veterans’ Affairs of the Senate, and the Committee on Veterans’ Affairs of the House of Representatives an initial report on the activities of the Academies under the agreement.
(B)The report submitted under subparagraph (A) shall include the following:
(i)The determinations described in subsection (d).
(ii)A full explanation of the scientific evidence and reasoning that led to such determinations.
(iii)Any recommendations of the Academies under subsection (f).
(2)Under an agreement between the Secretary and the Academies under this section, not less frequently than once every two years after the date on which the initial report is submitted under paragraph (1)(A), the Academies shall submit to the Secretary, the Committee on Veterans’ Affairs of the Senate, and the Committee on Veterans’ Affairs of the House of Representatives an updated report on the activities of the Academies under the agreement.
(h)
(1)If the Secretary is unable within the time period prescribed in subsection (b)(2) to enter into an agreement with the Academies for the purposes of this section on terms acceptable to the Secretary, the Secretary shall seek to enter into an agreement for the purposes of this section with another appropriate scientific organization that—
(A)is not part of the Federal Government;
(B)operates as a not-for-profit entity; and
(C)has expertise and objectivity comparable to that of the Academies.
(2)If the Secretary enters into an agreement with another organization as described in paragraph (1), any reference in this subchapter to the Academies shall be treated as a reference to the other organization.
Subchapter I · General
1101Definitions#
For the purposes of this chapter—
(1)The term “veteran” includes a person who died in the active military, naval, air, or space service.
(2)The term “period of war” includes, in the case of any veteran—
(B)any period of continuous service performed by such veteran after December 31, 1946, and before July 26, 1947, if such period began before January 1, 1947.
(3)The term “chronic disease” includes— Anemia, primary Arteriosclerosis Arthritis Atrophy, progressive muscular Brain hemorrhage Brain thrombosis Bronchiectasis Calculi of the kidney, bladder, or gallbladder Cardiovascular-renal disease, including hypertension Cirrhosis of the liver Coccidioidomycosis Diabetes mellitus Encephalitis lethargica residuals Endocarditis Endocrinopathies Epilepsies Hansen’s disease Hodgkin’s disease Leukemia Lupus erythematosus, systemic Myasthenia gravis Myelitis Myocarditis Nephritis Organic diseases of the nervous system Osteitis deformans (Paget’s disease) Osteomalacia Palsy, bulbar Paralysis agitans Psychoses Purpura idiopathic, hemorrhagic Raynaud’s disease Sarcoidosis Scleroderma Sclerosis, amyotrophic lateral Sclerosis, multiple Syringomyelia Thromboangiitis obliterans (Buerger’s disease) Tuberculosis, active Tumors, malignant, or of the brain or spinal cord or peripheral nerves Ulcers, peptic (gastric or duodenal) and such other chronic diseases as the Secretary may add to this list.
(4)The term “tropical disease” includes— Amebiasis Blackwater fever Cholera Dracontiasis Dysentery Filiariasis Hansen’s disease Leishmaniasis, including kala-azar Loiasis Malaria Onchocerciasis Oroya fever Pinta Plague Schistosomiasis Yaws Yellow fever and such other tropical diseases as the Secretary may add to this list.
1102Special provisions relating to surviving spouses#
(a)No compensation shall be paid to the surviving spouse of a veteran under this chapter unless such surviving spouse was married to such veteran—
(1)before the expiration of fifteen years after the termination of the period of service in which the injury or disease causing the death of the veteran was incurred or aggravated; or
(2)for one year or more; or
(3)for any period of time if a child was born of the marriage, or was born to them before the marriage.
(b)Subsection (a) shall not be applicable to any surviving spouse who, with respect to date of marriage, could have qualified as a surviving spouse for death compensation under any law administered by the Secretary in effect on December 31, 1957.
1103Special provisions relating to claims based upon effects of tobacco products#
(a)Notwithstanding any other provision of law, a veteran’s disability or death shall not be considered to have resulted from personal injury suffered or disease contracted in the line of duty in the active military, naval, air, or space service for purposes of this title on the basis that it resulted from injury or disease attributable to the use of tobacco products by the veteran during the veteran’s service.
(b)Nothing in subsection (a) shall be construed as precluding the establishment of service connection for disability or death from a disease or injury which is otherwise shown to have been incurred or aggravated in active military, naval, air, or space service or which became manifest to the requisite degree of disability during any applicable presumptive period specified in section 1112 or 1116 of this title.
1104Cost-of-living adjustments#
(a)In the computation of cost-of-living adjustments for fiscal years 1998 through 2013 in the rates of, and dollar limitations applicable to, compensation payable under this chapter, such adjustments shall be made by a uniform percentage that is no more than the percentage equal to the social security increase for that fiscal year, with all increased monthly rates and limitations (other than increased rates or limitations equal to a whole dollar amount) rounded down to the next lower whole dollar amount.
(b)For purposes of this section, the term “social security increase” means the percentage by which benefit amounts payable under title II of the Social Security Act (42 U.S.C. 401 et seq.) are increased for any fiscal year as a result of a determination under section 215(i) of such Act (42 U.S.C. 415(i)).
Subchapter V · Peacetime death compensation
1141Basic entitlement#
The surviving spouse, child or children, and dependent parent or parents of any veteran who died before January 1, 1957, as the result of injury or disease incurred in or aggravated by active military, naval, air, or space service, in line of duty, during other than a period of war, shall be entitled to receive compensation as hereinafter provided in this subchapter.
United States Government work; public domain under 17 U.S.C. § 105.